MAL, a potential immunotherapy target, is associated with poor prognosis in cancer patients.

The MAL gene encodes Myelin and Lymphocyte Protein, mainly expressed in T cells with immunomodulatory effects, showing the potential as a target for immunotherapy. However, the mechanism of MAL in the regulation of immune infiltration and its association with the prognosis in pan-cancer patients remain elusive. We used the TCGA, TIMER2.0, GTEx, UCSC, and TISCH databases and the R programming tool to explore the role of MAL in cancers. MAL was differently expressed in the majority of malignancies relative to the matched healthy controls. Patients with low MAL levels had adverse survival outcomes in the BRCA and LUAD cohorts. In all cancer types, MAL showed a significant correlation to specific immune-subpopulation abundance in particular T cells as well as B cells. MAL was also implicated in immunological pathways in BRCA and LUAD, suggesting the important role of MAL in cancer immune regulation. In conclusion, the pan-cancer study indicates that MAL with excellent prognostic value is a potential immunotherapy target in multiple cancers.

Diagnosing cervical lymph node metastasis in oral squamous cell carcinoma based on third-generation dual-source, dual-energy computed tomography.

OBJECTIVES: To investigate the potential of dual-energy computed tomography (DECT) parameters in identifying metastatic cervical lymph nodes in oral squamous cell carcinoma (OSCC) patients and to explore the relationships between DECT and pathological features. METHODS: Clinical and DECT data were collected from patients who underwent radical resection of OSCC and cervical lymph node dissection between November 2019 and June 2021. Microvascular density was assessed using the Weidner counting method. The electron density (ED) and effective atomic number (Zeff) in non - contrast phase and iodine concentration (IC), normalized IC, slope of the energy spectrum curve (λHU), and dual-energy index (DEI) in parenchymal phase were compared between metastatic and non - metastatic lymph nodes. Student's t-test, Pearson's rank correlation, and receiver operating characteristic curves were performed. RESULTS: The inclusion criteria were met in 399 lymph nodes from 103 patients. Metastatic nodes (n = 158) displayed significantly decreased ED, IC, normalized IC, λHU, and DEI values compared with non-metastatic nodes (n = 241) (all p < 0.01). Strong correlations were found between IC (r = 0.776), normalized IC (r = 0.779), λHU (r = 0.738), DEI (r = 0.734), and microvascular density. Area under the curve (AUC) for normalized IC performed the highest (0.875) in diagnosing metastatic nodes. When combined with the width of nodes, AUC increased to 0.918. CONCLUSION: DECT parameters IC, normalized IC, λHU, and DEI reflect pathologic changes in lymph nodes to a certain extent, and aid for detection of metastatic cervical lymph nodes from OSCC. KEY POINTS: • Electron density, iodine concentration, normalized iodine concentration, λHU, and dual-energy index values showed significant differences between metastatic and non-metastatic nodes. • Strong correlations were found between iodine concentration, normalized iodine concentration, slope of the spectral Hounsfield unit curve, dual-energy index, and microvascular density. • DECT qualitative parameters reflect the pathologic changes in lymph nodes to a certain extent, and aid for the detection of metastatic cervical lymph nodes from oral squamous cell carcinoma.

Different observation period of exercise training in amyotrophic lateral sclerosis patients: A meta-analysis.

Objective: The purpose of this meta-analysis was to evaluate the effect of more intensive exercise training on the functional ability of patients with amyotrophic lateral sclerosis. Methods: Randomized controlled trials on exercise training in amyotrophic lateral sclerosis patients were retrieved from PubMed, Embase, Web of Science, Cochrane Library and other databases, and meta-analysis was conducted using a fixed effect model or random effect model. Sensitivity analysis was used as a means to study heterogeneity. Results: A total of 8 randomized controlled trials involving 330 patients with amyotrophic lateral sclerosis were included in this study. The results showed that there was statistical significance in the influence of more intensive exercise training on amyotrophic lateral sclerosis Functional Rating Scale in the short term (0-4 months) and the medium term (5-8 months) (P < 0.05). There was no significant difference in the effect of the amyotrophic lateral sclerosis Functional Rating Scale-Revised in the short term (0-4 months) or long term (9-12 months) (P ≥ 0.05). In the medium term (5-8 months), there was statistical significance (P < 0.05). There was no significant difference in Forced vital capacity (FVC%) in the short term (0-4 months) (P > 0.05). Conclusion: More intensive exercise training may slow the decline in functional score of amyotrophic lateral sclerosis patients, and more studies should be carried out in the future to verify the effect of more intensive exercise training in patients with amyotrophic lateral sclerosis.

Application Value of the Motor Unit Number Index in Patients With Kennedy Disease.

The aim of this study was to evaluate the usefulness of the motor unit number index (MUNIX) technique in Kennedy disease (KD) and test the correlation between the MUNIX and other clinical parameters. The MUNIX values of the bilateral deltoid, abductor digiti minimi (ADM), quadriceps femoris (QF), and tibialis anterior (TA) were determined and compared with the course of the disease. The MUNIX sum score was calculated by adding the MUNIX values of these 8 muscles. Disability was evaluated using the spinal and bulbar muscular atrophy functional rating scale (SBMAFRS). The MUNIX scores of patients with KD were negatively correlated with the course of the disease (p < 0.05), whereas their motor unit size index (MUSIX) scores were positively correlated with the course the of disease (p < 0.05). MUNIX sum scores were correlated with SBMAFRS scores (r = 0.714, p < 0.05). MUNIX was more sensitive than compound muscle action potentials or muscle strength as an indicator of neuron loss and axonal collateral reinnervation. The MUNIX sum score is an objective and a reliable indicator of disease progression, and it is a potential choice for therapeutic clinical trials. The MUNIX can assess the functional loss of motor axons and is correlated with disability. The MUNIX sum score may be especially suitable as an objective parameter.

Modeling habitat suitability for Yunnan Snub-nosed monkeys in Laojun Mountain National Park.

We provide new information on Yunnan snub-nosed monkey (Rhinopithecus bieti) behavioral ecology, contributing to future conservation efforts within the Laojun Mountain National Park. Habitat evaluation procedures are used to quantify the value of land as a habitat for a species. We analyzed environmental variables hypothesized to influence habitat suitability for Yunnan snub-nosed monkeys, and mapped the distribution of suitable habitats across the study area and adjacent areas. Spatial analysis with GPS data was conducted to investigate home-range change of these monkeys. Predictor variables were generated using ArcMap and R programming language. We prepared 34 environmental variables at 30-m spatial resolution. Maxent was used to analyze environmental variables that contributed to suitability. Using satellite remote sensing and GIS, we modeled the distribution of suitable habitat for Yunnan snub-nosed monkeys in the Jinsichang area of the Laojun Mountains in China. This study did not describe the frequency or intensity of habitat use. Habitat suitability was affected by several variables, the most influential, as determined by permutation importance, being mean diurnal temperature range (31.6%), precipitation during the wettest quarter of the year (30.4%), average annual precipitation (17%), normalized difference vegetation index (5%), wetness (4.6%), and aspect (4.5%). This habitat suitability model provides information about the current distribution of Yunnan snub-nosed monkeys, which is important for appropriate implementation of conservation actions.

Validation and Evaluation of the Core Nursing Outcomes Evaluation System for Inpatients with Stroke.

OBJECTIVE: To evaluate the reliability, validity, responsiveness, importance, and application level of the Core Nursing Outcomes Evaluation System for inpatients with stroke. METHODS: The reliability, validity, responsiveness, importance, and application level were evaluated by expert scoring, clinical measurement, and questionnaire survey. RESULTS: The scale-level content validity index (S-CVI) and item-level content validity index (I-CVI) were >0.8. The scoring of intraclass coefficient of all indicators was >0.600 (p < .001). There were significant differences in the total scores among patients with different severities (p < .001). Compared with total scores at admission, the total scores at discharge were significantly improved (p < .01). The importance and application level scores of all indexes are >4.5 points. CONCLUSION: The system has higher reliability, validity, responsiveness, and importance, but the application of each dimension is disproportionate. Stroke is an acute cerebrovascular disease characterized by cerebral ischemia and hemorrhagic injury. Epidemiological findings revealed that stroke is the second leading cause of death and the leading cause of disability in the world (Feigin et al., 2014). Epidemiological survey of 600,000 people in China showed that the prevalence of stroke has been increasing over the past 30 years (Sun & Wang, 2018). At present, stroke has become the first cause of death among Chinese residents (Wang, 2018; Zhou et al., 2016). In surviving patients with stroke, more than 60% of patients had different degrees of neurological dysfunction (Wang, Liu, Yang, Peng, & Wang, 2018), about 40% of them had severe disabilities (You & Wu, 2016). About 60% of first onset stroke patients were associated with higher risk of recurrence (Wang et al., 2018). With increasing age, the global burden of stroke is becoming heavier and heavier (Johnston, Mendis & Mathers, 2009). In 2015, the cost of stroke treatment in China reached about 29.2 billion RMB, bringing heavy economic burden to families as well as society (Ma, 2018). From the above data, we deduced that stroke has characteristics of high prevalence rate, high disability rate, high mortality rate, and high recurrence rate. It is one of the important causes of death and disability, seriously threatening human health and has become an important public health problem faced by Chinese society currently.

Correction to: Modeling habitat suitability for Yunnan Snub­nosed monkeys in Laojun Mountain National Park.

The correct name of the last author should be ''Tetsuro Matsuzawa'', and not ''Tetsuro Matsuzwa'' as given in the original publication of the article.

Creation and Location-Specific Revision of a Core Nursing Outcomes Evaluation System Based on Nursing Outcomes Classification for Stroke Inpatients in China.

PURPOSE: To screen and create a core nursing outcomes evaluation index system based on NOC for stroke inpatients in China. METHODS: This study adopted the method of Delphi expert consultation, with the degree of consent >4.0 points and the coefficient of variation <0.25 as the standard for inclusion of indexes. RESULTS: The evaluation index system established in this study includes five first-grade indexes, 15 second-grade indexes, and 58 third-grade indexes. CONCLUSION: The evaluation index system of core nursing outcomes for stroke inpatients in China has good specificity and reliability. PRACTICE IMPLICATIONS: The evaluation index system of core nursing outcomes provides a standardized location-specific tool for clinical nurses to evaluate the nursing quality and intervention effect for stroke inpatients in China.

Zebularine Promotes Hepatic Differentiation of Rabbit Bone Marrow Mesenchymal Stem Cells by Interfering with p38 MAPK Signaling.

Demethylating agent zebularine is reported to be capable of inducing differentiation of stem cells by activation of methylated genes, though its function in hepatocyte differentiation is unclear. p38 signal pathway is involved in differentiation of hepatocytes and regulating of DNA methyltransferases 1 (DNMT1) expression. However, little is known about the impact of zebularine on bone marrow mesenchymal stem cells (BMMSCs) and p38 signaling during hepatic differentiation. The present study investigated the effects of zebularine on hepatic differentiation of rabbit BMMSCs, as well as the role of p38 on DNMT1 and hepatic differentiation, with the aim of developing a novel strategy for improving derivation of hepatocytes. BMMSCs were treated with zebularine at concentrations of 10, 20, 50, and 100 µM in the presence of hepatocyte growth factor; changes in the levels of hepatic-specific alpha-fetoprotein and albumin were detected and determined by RT-PCR, WB, and immunofluorescence staining. Expression of DNMT1 and phosphorylated p38 as well as urea production and ICG metabolism was also analyzed. Zebularine at concentrations of 10, 20, and 50 µM could not affect cell viability after 48 h. Zebularine treatment leads to an inhibition of DNMT activity and increase of hepatic-specific proteins alpha-fetoprotein and albumin in BMMSCs in vitro; zebularine addition also induced expression of urea production of and ICG metabolism. p38 signal was activated in BMMSCs simulated with HGF; inhibition of p38 facilitated the synthesis of DNMT1 and albumin in cells. Zebularine restrained DNMT1 and phosphorylated p38 which were induced by HGF. Therefore, this study demonstrated that treatment with zebularine exhibited terminal hepatic differentiation of BMMSCs in vitro in association with hepatocyte growth factor; p38 pathway at least partially participates in zebularine-induced hepatic differentiation of rabbit BMMSCs.

Leptin deficiency and beta-cell dysfunction underlie type 2 diabetes in compound Akt knockout mice.

Phenotypic analyses of mice null for the individual Akt isoforms suggested that they are functionally distinct and that only Akt2 plays a role in diabetes. We show here that Akt isoforms play compensatory and complementary roles in glucose homeostasis and diabetes. Insulin resistance in Akt2(-/-) mice was inhibited by haplodeficiency of Pten, suggesting that other Akt isoforms can compensate for Akt2 function. Haplodeficiency of Akt1 in Akt2(-/-) mice, however, converts prediabetes to overt type 2 diabetes, which is also reversed by haplodeficiency of Pten. Akt3 does not appear to contribute significantly to diabetes. Overt type 2 diabetes in Akt1(+/-) Akt2(-/-) mice is manifested by hyperglycemia due to beta-cell dysfunction combined with impaired glucose homeostasis due to markedly decreased leptin levels. Restoring leptin levels was sufficient to restore normal blood glucose and insulin levels in Akt1(+/-) Akt2(-/-) and Akt2(-/-) mice, suggesting that leptin-deficiency is the predominant cause of diabetes in these mice. These results uncover a new mechanism linking Akt to diabetes, provide a therapeutic strategy, and show that diabetes induced as a consequence of cancer therapy, via Akt inhibition, could be reversed by leptin therapy.